Predicting Success

This blog is about the individual.

1. Page 4 of the Fall 2008 Stuttering Foundation Newsletter reports http://www.stutteringhelp.org/Portals/English/fall_2008_newsletter.pdf included the following concept: "For the field of psychotherapy... on average, treatment is effective regardless of the particular intervention approach used...statistical differences in effectiveness of various treatments are likely to be due to client variability and clinician expertise rather than the specific treatment approach itself." For several years, I have heard the off-handed comment made in workshops that it is the clinician-client relationship, not the specific treatmet method, that best predicts successful therapy. Walter Manning, Ph.D. has presented on this topic, but I am still looking for the reference.

2. My husband brought to my attention a Malcolm Gladwell piece in the December 15 New Yorker Magazine titled Most Likely to Succeed http://gladwell.typepad.com/gladwellcom/2008/12/teachers-and-quarterbacks.html . In this article, Gladwell talks about how difficult it is to judge if a newly drafted quarterback will make it in the NFL, regardless of how talented and successful his college career. Football scout Dan Shonka describes what he looks for in young talent: when a player faces failure, will he "... throw it away and play another day. Will he (the quarterback) stand in there and take a hit, with a guy breathing down his face..." Speech can sometimes be this kind of challange.

Yet, Shonka says that even these qualities do not guarantee success in the NFL and Gladwell describes similarities between scouting for football players and scouting for classroom teachers. With respect to speech therapy, how can consumers predict which SLPs or programs will lead to successful outcomes? I don't think "outcome data" adresses this issue completely. As an SLP, I've learned only to work with clients that I feel benefit from my teaching style. My practice is not like a retail store or even a doctor's office. It consists of carefully chosen clientele that I look forward to seeing and who make consistent progress.

3. I learned this week that a gifted SLP who was a colleague of mine at the Easter Seal Society of Allegheny County in Pittsburgh, PA, has died of cancer. Another is gravely ill. This prompts me to reminisce. I was so fortunate to have worked with such good people when I left college and entered the field of speech language pathology. I didn't know it at the time, but the likelihood of my success in this field greatly increased when I became a member of the Department of Communication Disorders at the Easter Seal Society. The high standards, warm feelings and mutual respect between SLPs nurtured there laid the foundation for my current practice.

It's the people that matter. SLPs must follow best practice, which is now considered "Evidence Based Practice." Consumers struggle with insurance coverage, school district guidelines, and choosing from a host of treatment options. Yet in the end, it is the people that matter. There are many noteworthy, ethical professionals in the field of stuttering. Here are a few of my favorites: John Ahlbach, Alan Badmington, Russ Hicks, Michael Sugarman, Walter Manning, Marty Jezer, Gerald Johnson, Judy Kuster, Barry Guitar, Phil Schnieder, David Ramig, Cheryl Gottwald, Marybeth Allen and Louise Heite. If you Google these names, I predict you will locate high quality information.